Human chorionic gonadotrophin immunoactivity in cystic intracranial tumours

Honegger, Jürgen; Mann, Klaus; Thlerauf, Paul; Zrinzo, Anthony; Fahlbusch, Rudolf

doi:10.1111/j.1365-2265.1995.tb01870.x

Cited by 22 publications

(17 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Interestingly, treatment of craniopharyngioma cell cultures by progesterone causes reduced [ 3 H]thymidine uptake and increased oxidative 17␤-estradiol oxidoreductase activity (resulting in significantly increased estrone formation from the added 17␤-estradiol substrate) (64); the therapeutic implications of these biological actions remain to be investigated. In their cystic fluid, human chorionic gonadotropin (61,66), IGF-I, IGF-II, and IGF-binding proteins (67), as well as IL-1␣, IL-6, and TNF-␣ have been detected (68). The significance of these findings also remains to be established.…”

Section: Pathologymentioning

confidence: 87%

Craniopharyngiomas

et al. 2006

View full text Add to dashboard Cite

Craniopharyngiomas are rare, mainly sellar/parasellar, epithelial tumors diagnosed during childhood or adult life. Histologically, two primary subtypes have been recognized (adamantinomatous and papillary) with an as yet, unclarified pathogenesis. They may present with a variety of manifestations (neurological, visual, and hypothalamo-pituitary). Despite their benign histological appearance, they often show an unpredictable growth pattern, which, combined with the lack of randomized studies, poses significant difficulties in the establishment of an optimal therapeutic protocol. This should focus on the prevention of recurrence(s), improvement of survival, reduction of the significant disease and treatment-related morbidity (endocrine, visual, hypothalamic, neurobehavioral, and cognitive), and preservation of the quality of life. Currently, surgical excision followed by external beam irradiation, in cases of residual tumor, is the main treatment option. Intracystic irradiation or bleomycin, stereotactic radiosurgery, or radiotherapy and systemic chemotherapy are alternative approaches; their place in the management plan remains to be assessed in adequately powered long-term trials. Apart from the type of treatment, the identification of clinical and imaging parameters that will predict patients with a better prognosis is difficult. The central registration of patients with these challenging tumors may provide correlates between treatments and outcomes and establish prognostic factors at the pathological or molecular level that may further guide us in the future.

show abstract

Section: Pathologymentioning

confidence: 87%

Craniopharyngiomas

et al. 2006

View full text Add to dashboard Cite

show abstract

“…Serum tumor marker assays alone may fail to exclude mixed germ cell components and elevations of CSF bHCG have been reported in other tumors such as pituitary adenoma, craniopharyngioma and as well as benign conditions such as arachnoidal cysts. 3, 9 Several investigators have argued that the multi-focal midline presentation is so uniquely associated with germinoma that biopsy confirmation is not be necessary. 5 However, there are a growing number of case reports citing an exception to this observation.…”

Section: Discussionmentioning

confidence: 99%

“…bHCG is not frequently used as a surrogate diagnostic tool in lieu of a biopsy for germinoma because it is frequently undetectable in serum at diagnosis and low levels have been reported in other conditions. 2, 3 Histologic confirmation currently serves as the standard of care. 4 One exception may be patients with multi-focal (pineal/suprasellar) presentations since the majority harbor a pure germinoma.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic sensitivity of serum and lumbar CSF bHCG in newly diagnosed CNS germinoma

Allen

Chacko

Donahue

et al. 2012

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Background Marked elevations of AFP and bHCG in serum or CSF may serve as surrogate diagnostic markers in lieu of histology for primary CNS mixed, malignant germ cell tumors. There is less information on the diagnostic sensitivity of bHCG assays in germinoma. Procedure We report baseline serum and lumbar CSF bHCG values in 58 newly diagnosed, histologically confirmed germinoma patients gathered from 2 prospective clinical trials which required that patients have a normal AFP and bHCG ≤50 mIU/ml in serum and lumbar CSF. Results The location of the primary tumors was: suprasellar(23); pineal(20); suprasellar/pineal(9) and other sites(6). The mean age of the study population was 13.5 (4.3–25.9) years. A total of 23(40%) patients had elevations of bHCG in either serum or CSF, 20(34.5%) of whom had only bHCG elevations in CSF. The patients bHCG profiles were divided into 4 categories: I (normal serum and lumbar CSF bHCG) - 35(60%); II (normal serum and elevated CSF bHCG) - 20(34.5%); III (elevated serum and CSF bHCG) - 2(3.5%) and IV (elevated serum and normal CSF bHCG) - 1(2%). The median CSF bHCG level was 7.7(2.5–16) in the 22 patients with abnormal CSF values and the lumbar value was higher than the serum value in 20 of 23(87%) patients with bHCG elevations. Conclusions Lumbar CSF was a more informative screen for bHCG than serum but the majority of patients (60%) had normal bHCG values at diagnosis. Until a more sensitive tumor marker for germinoma is devised, histologic confirmation remains the standard of care.

show abstract

“…[1] However, the immunohistochemical expression of HCG-β had been detected in various tumors other than GCTs, including cystic pituitary adenomas, Rathke's cleft cysts, and craniopharyngiomas. [2310] In this case, we could not distinguish a craniopharyngioma from a GCT by the detection of HCG-β in the CSF.…”

Section: Discussionmentioning

confidence: 72%

A craniopharyngioma with spontaneous involution of a gadolinium-enhanced region on magnetic resonance imaging

et al. 2014

View full text Add to dashboard Cite

Background:It has not been reported previously that the solid enhancing portion of a craniopharyngioma has involuted without a change in cyst size.Case Description:We herein report a case of a craniopharyngioma with spontaneous involution of a solid gadolinium (Gd)-enhanced region on magnetic resonance imaging (MRI). A 44-year-old female was referred to our department with a mass on MRI associated with headaches and polyuria. The images showed a suprasellar cystic lesion progressing from the posterior pituitary lobe to the right hypothalamus along the pituitary stalk. Examinations of the cerebrospinal fluid showed aseptic meningitis and a positive titer of beta-human chorionic gonadotropin (HCG-β) preoperatively. The hypothalamic lesion became enlarged over the following 3 weeks, and a biopsy of the posterior pituitary lobe was performed via the endonasal transsphenoidal approach under a preoperative diagnosis of a germ cell tumor (GCT). The histological diagnosis was a craniopharyngioma, and the patient's postoperative findings on MRI were atypical: The solid Gd-enhanced region in the hypothalamus had spontaneously decreased in size and the peritumoral edema had improved, although the biopsy site in the posterior pituitary lobe was distant from the area of shrinkage. We speculated that the involutional portion on MRI mimicking a tumor was actually the normal hypothalamus, which was abnormally enhanced due to a disruption of the blood-brain barrier caused by the craniopharyngioma.Conclusion:Gd-enhanced regions of parenchyma neighboring the cysts of craniopharyngioma should be carefully managed, taking into consideration the possibility of the enhancement of normal tissue.

show abstract

Human chorionic gonadotrophin immunoactivity in cystic intracranial tumours

Cited by 22 publications

References 19 publications

Craniopharyngiomas

Craniopharyngiomas

Diagnostic sensitivity of serum and lumbar CSF bHCG in newly diagnosed CNS germinoma

A craniopharyngioma with spontaneous involution of a gadolinium-enhanced region on magnetic resonance imaging

Contact Info

Product

Resources

About